Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Neurosurgery. 2019 Jan 1;84(1):179-189. doi: 10.1093/neuros/nyy048.
Stent-assisted coiling (SAC) is increasingly being performed as intervention for wide-neck intracranial aneurysms. The NeuroForm Atlas Stent (CE-marked; Stryker, Kalamazoo, Michigan) is relatively new.
To evaluate the effectiveness and safety of NeuroForm Atlas SAC for intracranial aneurysms in the first such study.
We retrospectively analyzed data from all patients treated with the NeuroForm Atlas SAC of an intracranial aneurysm, both ruptured and unruptured, between June 2015 and December 2016. Primary end-points were favorable clinical outcomes (modified Rankin scale score 0-2) and successful aneurysm occlusion (Raymond-Roy class I/II), both at 6-mo follow-up. Secondary end-points were the occurrence of intervention-related complications leading to permanent neurological deficit, the occurrence of intervention-related stroke and neurological death, immediate aneurysm occlusion, rupture (or rerupture) of the aneurysm, and recanalization.
Twenty-seven consecutive patients, 10 with ruptured saccular wide-neck aneurysms, were treated with NeuroForm Atlas SAC. At 6-mo follow-up, 18/26 (69.2%) survivors had successful aneurysm occlusion and 22/26 (84.6%) had favorable clinical outcome. One patient had died of a cause unrelated to treatment. No intervention-related complications leading to permanent neurological deficit occurred. However, intraprocedural thromboembolic complications occurred in 4/27 patients (14.8%), and ischemic stroke related to treatment occurred in 4/26 (15.4%). No hemorrhagic complications were observed.
NeuroForm Atlas SAC is a feasible way to treat ruptured and unruptured wide-neck aneurysms that are not amenable to conventional coiling or clipping. Aneurysm occlusion and favorable clinical outcome are consistent with previously reported rates for SAC of wide-neck aneurysms with other devices.
支架辅助弹簧圈栓塞术（SAC）越来越多地被用于治疗宽颈颅内动脉瘤。NeuroForm Atlas 支架（CE 标志；Stryker，密歇根州卡拉马祖）是一种相对较新的支架。
评估 NeuroForm Atlas SAC 治疗颅内宽颈动脉瘤的有效性和安全性，这是首次此类研究。
我们回顾性分析了 2015 年 6 月至 2016 年 12 月期间所有接受 NeuroForm Atlas SAC 治疗的颅内未破裂和破裂动脉瘤患者的数据。主要终点是 6 个月随访时的良好临床结果（改良 Rankin 量表评分 0-2）和成功的动脉瘤闭塞（Raymond-Roy 分级 I/II）。次要终点是导致永久性神经功能缺损的与介入相关的并发症、与介入相关的卒中或神经死亡、即刻动脉瘤闭塞、动脉瘤破裂（或再破裂）和再通的发生率。
27 例连续患者，10 例为破裂的囊状宽颈动脉瘤，接受 NeuroForm Atlas SAC 治疗。6 个月随访时，26 例幸存者中有 18 例（69.2%）动脉瘤闭塞成功，26 例中有 22 例（84.6%）临床结果良好。1 例患者因与治疗无关的原因死亡。无导致永久性神经功能缺损的与介入相关的并发症发生。然而，4/27 例（14.8%）患者发生术中血栓栓塞并发症，4/26 例（15.4%）患者发生与治疗相关的缺血性卒中。未观察到出血性并发症。
NeuroForm Atlas SAC 是一种可行的方法，可治疗常规弹簧圈栓塞或夹闭不可行的破裂和未破裂宽颈动脉瘤。动脉瘤闭塞和良好的临床结果与其他装置治疗宽颈动脉瘤的 SAC 报告的发生率一致。
